Individual provider Active NPI

Andrzej Bakiewicz, PTA

  • Physical Therapy Assistant
  • Utica, NY
National Provider Identifier
1043521172
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
004906-1 Issued in NY
Practice address
1601 Armory Dr
BLDG. B
Utica, NY 13501-5405
Phone
(315) 798-4040
NPI assigned
Jun 23, 2010
Last updated
Jun 23, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 004906-1 NY Primary

Addresses

Primary practice location

1601 Armory Dr
BLDG. B
Utica, NY 13501-5405

Mailing address

1601 Armory Dr
BLDG. B
Utica, NY 13501-5405
Phone (315) 798-4040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
004906-1NYMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277251200000",
    "number": "1043521172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 ARMORY DR",
            "address_2": "BLDG. B",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135015405",
            "telephone_number": "315-798-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 ARMORY DR",
            "address_2": "BLDG. B",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135015405",
            "telephone_number": "315-798-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKIEWICZ",
        "first_name": "ANDRZEJ",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-23",
        "last_updated": "2010-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "004906-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.